Active NPI
Kaitlin Adrian
- Speech-Language Pathologist
- Brownsburg, IN
National Provider Identifier
1003300054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22007390A
- Practice address
- 1353 E Main St
Brownsburg, IN 46112-1433 - Phone
- (317) 520-4748
- NPI assigned
- Jun 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 46003008A | IN | |
| Speech-Language Pathologist | 235Z00000X | 22007390A | IN | Primary |
Addresses
Primary practice location
1353 E Main St
Brownsburg, IN 46112-1433
Mailing address
1353 E Main St
Brownsburg, IN 46112-1433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300016142 | Medicaid | IN |
Other names 1
- Kaitlin Juergensen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22007390A | IN | MD | Speech-Language Pathologist |
| 46003008A | IN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaitlin Adrian, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Indianapolis, IN
- NPI 1881560316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1003300054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1353 E MAIN ST",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1353 E MAIN ST",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121433",
"telephone_number": "317-520-4748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADRIAN",
"first_name": "KAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-21",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "46003008A",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22007390A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300016142",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KAITLIN",
"last_name": "JUERGENSEN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.